Lymphedema

Lymphedema is the chronic swelling of a body part, usually an arm or leg. The most common cause of lymphedema in women is axillary lymph node removal, mastectomy, radiation or all three. The lymph system can be damaged by these treatments, causing lymph fluid accumulation in the affected extremity. Lymphedema may or may not occur immediately after surgery or several years later.

Symptoms

The following are the most common symptoms related to lymphedema.

• Arm feels full or heavy
• Skin feels tight
• Less movement or flexibility in the hand or wrist
• Difficulty fitting the arm into jacket or shirt sleeves
• Ring, watch and/or bracelet feels tight but you have not gained weight

If you have had lymph nodes removed or radiation treatment, you may want to examine your upper body in front of a mirror. If you notice any of the signs listed above and they last for one or two weeks, call your doctor or healthcare provider.

Call Your Healthcare Provider

It is important to speak with an expert regarding your symptoms. Call him if:

• You notice any extremity swelling with or without pain that lasts for one to two weeks.
• Any part of your affected arm or underarm area feels hot, is red or has sudden swelling. These symptoms could signal an infection and may require antibiotics.
• You have a temperature above 100.5 degrees Fahrenheit that is not related to a cold or flu.

Physical Therapy Treatment

If you are diagnosed with lymphedema, there is effective treatment to reduce the swelling, prevent it from getting worse and limit the risk of infection. Typically, the therapy is prescribed by your doctor and should be given by an experienced therapist. Mild to severe lymphedema most often is treated by a physical therapist with specialized training and expertise who will provide skin care, manual lymph drainage, compression therapy, exercise, special bandaging and fitting for a compression sleeve. Seeking and getting treatment early can lead to a shorter course of treatment.

Things to Remember

• Wear gloves while doing housework, gardening or other types of work that can result in even minor injuries. A skin lesion can increase the risk of unwanted infectious bacteria entering the tissue.
• Never allow an injection or the collection of blood in the affected arm or leg. Needles will pierce the skin, providing an entry point for infection.
• Never have your blood pressure checked in the affected arm or leg. The inflated blood pressure cuff further limits the circulation in an arm that already has poor lymph drainage.
• Avoid heavy lifting with the affected arm. Do not carry heavy handbags with over-the-shoulder straps. Lifting puts strain on the arm with poor lymph drainage.
• Avoid vigorous, repetitive movements against resistance with the affected arm or leg (rubbing, scrubbing, pushing or pulling). Physical exertion causes sudden blood flow through the muscle or tissue, further stressing an already compromised lymph system.
• Elevate the affected arm(s) or leg(s) whenever possible. This will help improve lymphatic drainage. Ask your doctor or physical therapist about any sports activities in which you participate, because some may aggravate the condition. However, swimming, biking, walking and specially designed ballet or yoga movements are encouraged. Physical exertion forces the damaged lymphatic system to try to do work that it cannot do.
• Avoid extreme temperature changes in bathing, washing dishes or sunbathing. Keep the limb protected from the sun. Heat increases the blood flow through the tissues. Sudden temperature changes cause undo stress on the weakened lymphatic system.
• Maintain good hygiene by keeping skin clean and dry with soap and deodorant made for sensitive skin. This will protect the skin from irritation and possible infection.
• Use an electric razor rather than a disposable razor. An electric razor will prevent puncturing the skin and possible infection.
• Do not wear tight jewelry or elastic bands around affected fingers, arms or legs. Constricting items will affect an already compromised lymphatic system.
• Avoid cutting cuticles when manicuring hands or having a pedicure. Any skin puncture risks introducing infection.
• Maintain your ideal weight through a well-balanced, low-salt diet; avoid smoking and alcoholic beverages. Unwanted weight gain will increase lymphatic swelling in the limbs.

Physical therapy treatment for lymphedema requires a referral from your physician, and care should be provided by a therapist certified in lymphedema management.

The information in this article does not substitute advice or information from your physician. Please consult your doctor for further information on specific medical conditions or symptoms.